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一项关于全科医生对在基层医疗环境中使用视频会诊的态度和观点的探索:一项定性试点研究。

An exploration of the attitudes and views of general practitioners on the use of video consultations in a primary healthcare setting: a qualitative pilot study.

作者信息

Randhawa Ratan S, Chandan Joht S, Thomas Tom, Singh Surinder

机构信息

1Medical Student,Research Department of Primary Care and Population Health,Hampstead,UCL,London,UK.

2Academic Foundation Year Doctor,City Hospital Birmingham,Birmingham,UK.

出版信息

Prim Health Care Res Dev. 2019 Jan;20:e5. doi: 10.1017/S1463423618000361. Epub 2018 Jun 18.

Abstract

BACKGROUND

In 2014, in the United Kingdom, the government made a commitment to spend £3.6 million on the introduction of Skype video calling consultations in general practice, however the efficacy of such technology has not yet been explored fully.AimThe study aimed to explore the views and attitudes of General Practitioners (GPs) towards video consultation in primary care; specifically, in three broad areas ∙The benefits of video consultations to patients and healthcare professionals.∙Potential problems with video consultation and its implementation.∙The cost-effectiveness of video consultation in this setting.

METHOD

A convenience sample of the views of 12 general practitioners across two primary care centres in North London were identified using topic guide based semi-structured interviews. A thematic framework approach was used to analyse the data collected to isolate main and sub-themes.FindingsThree main themes were identified 1.Technology - GPs expressed concerns about the ability of patients to use technology, the availability of technology and the quality of technology available.2.Utility - encompassing GP's ideas about the usefulness of video consultations to patients, practitioners and the doctor-patient relationship. GPs presented mixed views on the extent to which video consultation would be useful.3.Practicality - covering the views of GPs on implementation and effects on workload. GPs unanimously felt that it was not a practical substitute for face-to-face consultation. There were mixed feelings about it being used as an alternative to telephone consultation.

CONCLUSION

GPs did see potential benefits to using video consultations but also expressed concerns that need to be addressed if they are to have full confidence in the system. The views of those who are going to use video consultation as a means of increasing patient access are paramount if such tools are to be a core part of primary care.

摘要

背景

2014年,英国政府承诺投入360万英镑在全科医疗中引入Skype视频通话咨询服务,然而该技术的有效性尚未得到充分探索。

目的

本研究旨在探讨全科医生(GP)对基层医疗中视频咨询的看法和态度;具体而言,涉及三个主要方面:

∙ 视频咨询对患者和医疗专业人员的益处。

∙ 视频咨询及其实施过程中可能存在的问题。

∙ 在此背景下视频咨询的成本效益。

方法

通过基于主题指南的半结构化访谈,从伦敦北部两个基层医疗中心的12名全科医生中选取了一个便利样本。采用主题框架法对收集到的数据进行分析,以确定主要主题和子主题。

结果

确定了三个主要主题:

  1. 技术——全科医生对患者使用技术的能力、技术的可用性以及现有技术的质量表示担忧。

  2. 实用性——包括全科医生对视频咨询对患者、从业者以及医患关系的有用性的看法。全科医生对视频咨询在多大程度上有用存在不同看法。

  3. 实用性——涵盖全科医生对实施情况以及对工作量影响的看法。全科医生一致认为视频咨询不能实际替代面对面咨询。对于将其用作电话咨询的替代方式,看法不一。

结论

全科医生确实看到了使用视频咨询的潜在益处,但也表示如果要对该系统充满信心,还需要解决一些担忧。如果此类工具要成为基层医疗的核心组成部分,那么那些将视频咨询作为增加患者就医途径手段的人的看法至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9692/6476389/e90dc76c3924/S1463423618000361_fig1.jpg

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